Late development to a variety of chronic kidney disease, renal parenchyma after suffered severe damage, can be developed into uremia, is the main protein metabolism product retention on it, and water, electrolyte and acid-base balance disorders in clinical syndrome, chronic renal failure is a progressive stages of failed. Symptoms of uremia is very complex, affects internal organs of the body system and metabolism, and the corresponding clinical symptoms:
1, gastrointestinal disease, gastrointestinal symptoms are the first symptoms of uremia patients, is also one of the symptoms of most often present in patients with uremia, anorexia, abdominal discomfort as the main performance, early after nausea, vomiting, diarrhea, glossitis, mouth with urine smell and oral mucosa erosion, such as gastrointestinal bleeding, even cause digestive tract symptoms mainly retention of toxic substances, such as the guanidine class) as a result, the function of NS at the same time, increased urea from the digestive tract, under the effect of hydrolytic enzymes in bacteria and intestinal ammonia and ammonium carbonate, stimulate the gastrointestinal mucosa, causing gastrointestinal dysfunction and moderate amounts of intestinal mucosa inflammation and ulcers, in addition, the disorder of water, electrolyte and acid-base balance is also a cause of disease of the gastrointestinal tract.
2, mental, nervous system symptoms: main show is listlessness, fatigue, dizziness, headache, memory loss, insomnia, limb numbness, muscle loss of muscle weakness, hand, foot and burning pain, etc., in the late of uremia patients can appear uremic encephalopathy, main show is lethargy, irritability, delirious speech, muscle tremor, even twitch, convulsions, coma, etc., the causes of mental, neurological symptoms mainly metabolites retention, water and electrolyte balance disorder and metabolic acidosis, the result of joint action of the NS hypertension and neurological disorder them (including slow nerve impulse conduction), may be associated with "the molecules of a material" retention.
3, disease of cardiovascular system: uremia often have blood pressure increases, the incidence of high blood pressure can reach 80-90%, generally is moderately elevated blood pressure, the reason is mainly due to the water sodium retention in blood volume increases, the part also increased and renin activity, renal step-down material such as prostaglandins, slow excitation in peptide secretion decreased, activity and so on, long-term high blood pressure can hypertensive vascular lesions, and finally lead to renal small A hardening, renal small A hardening and can accelerate the deterioration of renal function, persistent hypertension and anemia caused heart burden and lipid metabolism caused by coronary A, hardening produce urine toxicity of cardiomyopathy, clinically in heart failure, cardiac arrhythmias and conduction block, etc. In addition, the toxicity of urinary cp patients often feel pain in your area before the heart is frowsty, tingling, or a squeezing pain, then the patient before the heart area fibrin often can be heard, a few patient can have signs of pericardial effusion, the person that weigh can develop cardiac tamponade, the performance of the uremic pericarditis is in a critical condition, one of the mechanism is mainly with retention of toxic substances (including parathyroid hormone) increases.
4, hematopoietic system, mainly in significant anemia, and bleeding tendency, anemia is a clinical symptoms of uremia patients will have, the degree of anemia and weight is different, but often are positively correlation with the degree of renal insufficiency, the cause of anemia are kidney disease after RBC hormone reduce, suppresses the retention of the metabolites of RBC mature and damages the RBC membrane, shorten the life of RBC, the toxic substances in the blood, such as RBC hormone inhibitory factor inhibiting the activity of RBC hormone, reduce RBC generated. In addition, the urine poison patient anorexia, diarrhea, easily bleeding caused by lack of pressure, lack of folic acid and protein, the deficiency of the protein in the urine, the loss of the protein (especially made pressure loss) is the cause of anemia. Bleeding tendency mainly displays in the subcutaneous ecchymosis, nasal mucosa bleeding, gum bleeding, gastrointestinal bleeding, menorrhagia, women after injury bleeding, etc. This is mainly due to uremia platelet function is poor, easy to be destroyed, clotting factor activity and acidosis caused the increasing of blood capillary brittleness.
5, respiratory symptoms: breath smell of ammonia, breathing deep and long as acidosis, retention of metabolites can cause uremia bronchopneumonia and keratitis, and a corresponding clinical symptoms and signs.
6, skin manifestations: often lose luster, dry skin, desquamation, pigmentation, skin itching, and secondary parathyroid hormone and metastatic calcification have some relationship.
7, metabolic acidosis: uremia patients have varying degrees of metabolic acidosis, clinical manifestations such as fatigue, anorexia, nausea, vomiting, lethargy, light person CO2 - CP in 22-16 tendency between L (50-35 vol/uL), severe cases can be dropped to 4.5 tendency for L (below 10 vol/dl), and the causes of acidosis is mainly acid metabolites retention, renal tubular epithelial cells secrete hydrogen ions and the decline in the ability of synthetic ammonia, renal tubular reabsorption of bicarbonate ability is reduced, and diarrhoea result in loss of alkaline intestinal juice uremia patients are the cause of acidosis, severe acidosis patients often feel tired weakness, insensitive, breathing deep and long, even into a coma.
8, dehydration and edema: uremia patients of concentrated urine kidney function caused by poor polyuria, nocturia, a large number of moisture lost from the urine, coupled with uremia patients with anorexia, nausea, vomiting, diarrhea, so often the performance of the dehydration. Kidney, on the other hand, the drainage ability is poor, more water will retention in the body, cause oedema, kidney this tolerance to water and regulating ability is poor, easy to dehydration and the phenomenon of edema is a common characteristic, uremia, therefore, appropriate water supply will become one of the important measures for dealing with uremia.
9, electrolyte balance disorder:
(1) low Na and Na retention, uremia patients of Na adjustment ability is poor, prone to low Na hematic disease, the cause of mainly because of glomerular tube recovery Na hypofunction, and often use diuretics and cause loss of Na. When low Na Na (blood under 13 vmmol/L), because of difference of cells inside and outside osmotic pressure, water leads to cell into the cell edema (including cerebral edema), the patient can performance for fatigue, indifference, nausea, vomiting, irritability, confusion, the symptom such as convulsions coma, even in advanced disease, Na balance harder to maintain, if too much intake of Na, will retention dry the body, causing edema, hypertension, heart failure and even the people's livelihood.
(2) low K and high K hematic disease: early uremia patients can appear low K, common clinical symptoms are: weak countries and the whole body of numbness, serious ptosis, lift head, limb paralysis, difficulty breathing, also can appear abdominal distention, and may even bowel infarction Yin, etc. Uremia disease high K lower K hematic disease more common, the main clinical manifestations as K ion of the toxic effects of myocardial and skeletal muscles, the patient can have fatigue, muscle aches, action is slow, or muscle paralysis, even can speak hard, difficulty in breathing, arrhythmia, etc. K disorders cause caused mainly include anorexia diarrhea as well as the extensive use of diuretics cause serious low K, infection acidosis long-term use bartender K diuretics (such as body relief in sight-but ammonia, ammonia, benzene with organism) and losing inventory of blood or late anuria caused by severe high K hematic disease, in addition, there are very few patients may because of renal transport convoluted tubules lost adjust the function of K balance after illness.
(3) low Ga blood disease and high P: renal dysfunction, urinary P discharge reduction, result in higher P, elevated blood P in generally does not cause serious clinical symptoms, but blood P rises, compensatory to phosphate from intestinal mucosa and Ga combined into difficult soluble calcium, lead to the Ga can't absorb, and reduced the serum concentration of Ga and cause low Ga hematic disease, high blood P and low blood Ga can stimulate parathyroid secondary parathyroid gland to cause secondary hyperparathyroidism, lead to bone calcification dysfunction caused by uremia bone disease.
(4) high Mg concentration: high Mg blood disease with high K often exist at the same time, the patient first appeared tachycardia, nausea, vomiting, and then a heartbeat too slow, muscle weakness, lethargy, etc., when the serum Mg more than 6 mm/L respiratory failure can occur.
10, metabolic disorders: uremia patients have different degrees of metabolic disorder, due to malnutrition, protein synthesis, and the loss of protein in the urine, so many patients with hypoalbuminemia and angular, besides uremia patients often have hyperlipidemia, hyperlipidemia, causes of hyperlipidemia is mainly due to the results of the fat metabolism disorder.
11, secondary infection: uremia patients with humoral immunity and cellular immune function is low, so the ability to resist infection, easy to secondary infection, of which the lungs and urinary system are more likely to happen, and often no obvious systemic reactions after infection, therefore, should pay special attention to the change of the lung signs and urine.
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